{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:17:36Z","timestamp":1790716656281,"version":"4.1.0"},"reference-count":65,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Italian Ministry of Economy and Finance, program \u201c5 per mille\u201d"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Acquired adult flatfoot is a frequent deformity which implies multiple, complex and combined 3D modifications of the foot skeletal structure. The difficult thorough evaluation of the degree of severity pre-op and the corresponding assessment post-op can now be overcome by cone-beam (CBCT) technology, which can provide access to the 3D skeletal structure in weight-bearing. This study aims to report flatfoot deformities originally in 3D and in weight-bearing, with measurements taken using two different bone segmentation techniques. 21 such patients, with indication for surgical corrections, underwent CBCT (Carestream, US) while standing on one leg. From these scans, 3D models of each bone of the foot were reconstructed by using two different state-of-the-art segmentation tools: a semi-automatic (Mimics Innovation Suite, Materialise, Belgium), and an automatic (Bonelogic Ortho Foot and Ankle, Disior, Finland). From both reconstructed models, Principal Component Analysis was used to define anatomical reference frames, and original foot and ankle angles and other parameters were calculated mostly based on the longitudinal axis of the bones, in anatomical plane projections and in 3D. Both bone model reconstructions revealed a considerable valgus of the calcareous, plantarflexion and internal rotation of the talus, and typical Meary\u2019s angles in the lateral and transverse plane projections. The mean difference from these angles between semi-automatic and automatic segmentations was larger than 3.5 degrees for only 3 of the 32 measurements, and a large number of these differences were not statistically significant. CBCT and the present techniques for bone shape reconstruction finally provide a novel and valuable 3D assessment of complex foot deformities in weight-bearing, eliminating previous limitations associated to unloaded feet and bidimensional measures. Corresponding measurements on the bone models from the two segmentation tools compared well. Other more representative measurements can be defined in the future using CBCT and these techniques.<\/jats:p>","DOI":"10.1038\/s41598-021-95708-x","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T06:10:36Z","timestamp":1628489436000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Angular and linear measurements of adult flexible flatfoot via weight-bearing CT scans and 3D bone reconstruction tools"],"prefix":"10.1038","volume":"11","author":[{"given":"Maurizio","family":"Ortolani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Leardini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Pavani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Scicolone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Girolami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Bevoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Lullini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Durante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Berti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Belvedere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,9]]},"reference":[{"issue":"5","key":"95708_CR1","doi-asserted-by":"publisher","first-page":"293","DOI":"10.5435\/00124635-199509000-00005","volume":"3","author":"W Pedowitz","year":"1995","unstructured":"Pedowitz, W. & Kovatis, P. Flatfoot in the adult. J. Am. Acad. Orthop. Surg. 3(5), 293\u2013302. https:\/\/doi.org\/10.5435\/00124635-199509000-00005 (1995).","journal-title":"J. Am. Acad. Orthop. Surg."},{"issue":"3","key":"95708_CR2","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1016\/s1083-7515(03)00084-6","volume":"8","author":"DH Van Boerum","year":"2003","unstructured":"Van Boerum, D. H. & Sangeorzan, B. J. Biomechanics and pathophysiology of flat foot. Foot Ankle Clin. 8(3), 419\u2013430. https:\/\/doi.org\/10.1016\/s1083-7515(03)00084-6 (2003).","journal-title":"Foot Ankle Clin."},{"issue":"11","key":"95708_CR3","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1007\/s00132-020-03995-5","volume":"49","author":"N Gutteck","year":"2020","unstructured":"Gutteck, N., Schilde, S., Delank, K. S. & Arbab, D. Etiology, pathogenesis, clinical features, diagnostics and conservative treatment of adult flatfoot. Der Orthopade 49(11), 942\u2013953. https:\/\/doi.org\/10.1007\/s00132-020-03995-5 (2020).","journal-title":"Der Orthopade"},{"issue":"1","key":"95708_CR4","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s13047-018-0297-7","volume":"11","author":"P Caravaggi","year":"2018","unstructured":"Caravaggi, P., Sforza, C., Leardini, A., Portinaro, N. & Panou, A. Effect of plano-valgus foot posture on midfoot kinematics during barefoot walking in an adolescent population. J. Foot Ankle Res. 11(1), 55. https:\/\/doi.org\/10.1186\/s13047-018-0297-7 (2018).","journal-title":"J. Foot Ankle Res."},{"key":"95708_CR5","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.gaitpost.2019.06.002","volume":"72","author":"HS Shin","year":"2019","unstructured":"Shin, H. S. et al. Flatfoot deformity affected the kinematics of the foot and ankle in proportion to the severity of deformity. Gait Posture 72, 123\u2013128. https:\/\/doi.org\/10.1016\/j.gaitpost.2019.06.002 (2019).","journal-title":"Gait Posture"},{"issue":"10","key":"95708_CR6","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1177\/1071100720950722","volume":"41","author":"MS Myerson","year":"2020","unstructured":"Myerson, M. S. et al. Classification and nomenclature: Progressive collapsing foot deformity. Foot Ankle Int. 41(10), 1271\u20131276. https:\/\/doi.org\/10.1177\/1071100720950722 (2020).","journal-title":"Foot Ankle Int."},{"issue":"14","key":"95708_CR7","doi-asserted-by":"publisher","first-page":"e595","DOI":"10.5435\/JAAOS-D-19-00700","volume":"28","author":"MS Conti","year":"2020","unstructured":"Conti, M. S. & Ellis, S. J. Weight-bearing CT scans in foot and ankle surgery. J. Am. Acad. Orthop. Surg. 28(14), e595\u2013e603. https:\/\/doi.org\/10.5435\/JAAOS-D-19-00700 (2020).","journal-title":"J. Am. Acad. Orthop. Surg."},{"issue":"5","key":"95708_CR8","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1053\/j.jfas.2016.05.005","volume":"55","author":"BM Lamm","year":"2016","unstructured":"Lamm, B. M., Stasko, P. A., Gesheff, M. G. & Bhave, A. Normal foot and ankle radiographic angles, measurements, and reference points. J. Foot Ankle Surgery Official Publ. Am. College Foot Ankle Surgeons 55(5), 991\u2013998. https:\/\/doi.org\/10.1053\/j.jfas.2016.05.005 (2016).","journal-title":"J. Foot Ankle Surgery Official Publ. Am. College Foot Ankle Surgeons"},{"issue":"5","key":"95708_CR9","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1016\/j.fas.2019.07.008","volume":"26","author":"C Carrara","year":"2020","unstructured":"Carrara, C., Caravaggi, P., Belvedere, C. & Leardini, A. Radiographic angular measurements of the foot and ankle in weight-bearing: A literature review. Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons 26(5), 509\u2013517. https:\/\/doi.org\/10.1016\/j.fas.2019.07.008 (2020).","journal-title":"Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons"},{"issue":"4","key":"95708_CR10","doi-asserted-by":"publisher","first-page":"364","DOI":"10.4103\/ijri.IJRI_288_19","volume":"29","author":"K Pilania","year":"2019","unstructured":"Pilania, K., Jankharia, B. & Monoot, P. Role of the weight-bearing cone-beam CT in evaluation of flatfoot deformity. Indian J. Radiol. Imag. 29(4), 364\u2013371. https:\/\/doi.org\/10.4103\/ijri.IJRI_288_19 (2019).","journal-title":"Indian J. Radiol. Imag."},{"issue":"8","key":"95708_CR11","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1177\/1071100716646629","volume":"37","author":"EA Cody","year":"2016","unstructured":"Cody, E. A., Williamson, E. R., Burket, J. C., Deland, J. T. & Ellis, S. J. Correlation of talar anatomy and subtalar joint alignment on weightbearing computed tomography with radiographic flatfoot parameters. Foot Ankle Int. 37(8), 874\u2013881. https:\/\/doi.org\/10.1177\/1071100716646629 (2016).","journal-title":"Foot Ankle Int."},{"issue":"18","key":"95708_CR12","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.01366","volume":"99","author":"NC de Cesar","year":"2017","unstructured":"de Cesar, N. C. et al. Flexible adult acquired flatfoot deformity: Comparison between weight-bearing and non-weight-bearing measurements using cone-beam computed tomography. J. Bone Joint Surgery Am. 99(18), e98. https:\/\/doi.org\/10.2106\/JBJS.16.01366 (2017).","journal-title":"J. Bone Joint Surgery Am."},{"issue":"6","key":"95708_CR13","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1055\/s-0039-1697939","volume":"23","author":"A Leardini","year":"2019","unstructured":"Leardini, A. et al. Weight-bearing CT technology in musculoskeletal pathologies of the lower limbs: Techniques, initial applications, and preliminary combinations with gait-analysis measurements at the istituto ortopedico Rizzoli. Seminars Musculoskeletal Radiol. 23(6), 643\u2013656. https:\/\/doi.org\/10.1055\/s-0039-1697939 (2019).","journal-title":"Seminars Musculoskeletal Radiol."},{"issue":"2","key":"95708_CR14","doi-asserted-by":"publisher","first-page":"199","DOI":"10.3113\/FAI.2008.0199","volume":"29","author":"M Ferri","year":"2008","unstructured":"Ferri, M., Scharfenberger, A. V., Goplen, G., Daniels, T. R. & Pearce, D. Weightbearing CT scan of severe flexible pes planus deformities. Foot Ankle Int. 29(2), 199\u2013204. https:\/\/doi.org\/10.3113\/FAI.2008.0199 (2008).","journal-title":"Foot Ankle Int."},{"issue":"11","key":"95708_CR15","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.3113\/FAI.2011.1017","volume":"32","author":"M Kido","year":"2011","unstructured":"Kido, M. et al. Load response of the tarsal bones in patients with flatfoot deformity: In vivo 3D study. Foot Ankle Int. 32(11), 1017\u20131022. https:\/\/doi.org\/10.3113\/FAI.2011.1017 (2011).","journal-title":"Foot Ankle Int."},{"issue":"5","key":"95708_CR16","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1016\/j.clinbiomech.2013.04.004","volume":"28","author":"M Kido","year":"2013","unstructured":"Kido, M. et al. Load response of the medial longitudinal arch in patients with flatfoot deformity: In vivo 3D study. Clin. Biomech. (Bristol, Avon) 28(5), 568\u2013573. https:\/\/doi.org\/10.1016\/j.clinbiomech.2013.04.004 (2013).","journal-title":"Clin. Biomech. (Bristol, Avon)"},{"issue":"5","key":"95708_CR17","doi-asserted-by":"publisher","first-page":"361","DOI":"10.3113\/FAI.2010.0361","volume":"31","author":"SJ Ellis","year":"2010","unstructured":"Ellis, S. J. et al. Assessment of lateral hindfoot pain in acquired flatfoot deformity using weightbearing multiplanar imaging. Foot Ankle Int. 31(5), 361\u2013371. https:\/\/doi.org\/10.3113\/FAI.2010.0361 (2010).","journal-title":"Foot Ankle Int."},{"issue":"3","key":"95708_CR18","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1177\/1071100714557861","volume":"36","author":"W Probasco","year":"2015","unstructured":"Probasco, W. et al. Assessment of coronal plane subtalar joint alignment in peritalar subluxation via weight-bearing multiplanar imaging. Foot Ankle Int. 36(3), 302\u2013309. https:\/\/doi.org\/10.1177\/1071100714557861 (2015).","journal-title":"Foot Ankle Int."},{"issue":"6","key":"95708_CR19","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.fas.2017.05.010","volume":"24","author":"GC Kunas","year":"2018","unstructured":"Kunas, G. C. et al. Evaluation of peritalar subluxation in adult acquired flatfoot deformity using computed tomography and weightbearing multiplanar imaging. Foot Ankle Surg 24(6), 495\u2013500. https:\/\/doi.org\/10.1016\/j.fas.2017.05.010 (2018).","journal-title":"Foot Ankle Surg"},{"issue":"3","key":"95708_CR20","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1177\/1071100717740330","volume":"39","author":"A Barg","year":"2018","unstructured":"Barg, A. et al. Weightbearing computed tomography of the foot and ankle: Emerging technology topical review. Foot Ankle Int. 39(3), 376\u2013386. https:\/\/doi.org\/10.1177\/1071100717740330 (2018).","journal-title":"Foot Ankle Int."},{"issue":"5","key":"95708_CR21","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1302\/2058-5241.3.170066","volume":"3","author":"F Lintz","year":"2018","unstructured":"Lintz, F. et al. Weight-bearing cone beam CT scans in the foot and ankle. EFORT Open Rev. 3(5), 278\u2013286. https:\/\/doi.org\/10.1302\/2058-5241.3.170066 (2018).","journal-title":"EFORT Open Rev."},{"issue":"1","key":"95708_CR22","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1097\/CORR.0000000000001067","volume":"478","author":"ABM Burssens","year":"2020","unstructured":"Burssens, A. B. M. et al. Is lower-limb alignment associated with hindfoot deformity in the coronal plane? A weightbearing CT analysis. Clin. Orthop. Relat. Res. 478(1), 154\u2013168. https:\/\/doi.org\/10.1097\/CORR.0000000000001067 (2020).","journal-title":"Clin. Orthop. Relat. Res."},{"issue":"1","key":"95708_CR23","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/s00256-020-03532-7","volume":"50","author":"A Haldar","year":"2021","unstructured":"Haldar, A. et al. 3D imaging for hindfoot alignment assessment: A comparative study between non-weight-bearing MRI and weight-bearing CT. Skeletal Radiol. 50(1), 179\u2013188. https:\/\/doi.org\/10.1007\/s00256-020-03532-7 (2021).","journal-title":"Skeletal Radiol."},{"issue":"1S","key":"95708_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2020.102772","volume":"107","author":"F Lintz","year":"2021","unstructured":"Lintz, F., Beaudet, P., Richardi, G. & Brilhault, J. Weight-bearing CT in foot and ankle pathology. Orthop. Traumatol. Surg. Res. 107(1S), 102772. https:\/\/doi.org\/10.1016\/j.otsr.2020.102772 (2021).","journal-title":"Orthop. Traumatol. Surg. Res."},{"issue":"2","key":"95708_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5430\/ijdi.v1n2p1","volume":"1","author":"JB Ludlow","year":"2014","unstructured":"Ludlow, J. B. & Ivanovic, M. Weightbearing CBCT, MDCT, and 2D imaging dosimetry of the foot and ankle. Int. J. Diagnost. Imag. 1(2), 1. https:\/\/doi.org\/10.5430\/ijdi.v1n2p1 (2014).","journal-title":"Int. J. Diagnost. Imag."},{"issue":"11","key":"95708_CR26","doi-asserted-by":"publisher","first-page":"4955","DOI":"10.1002\/mp.13198","volume":"45","author":"JB Ludlow","year":"2018","unstructured":"Ludlow, J. B. Hand-wrist, knee, and foot-ankle dosimetry and image quality measurements of a novel extremity imaging unit providing CBCT and 2D imaging options. Med. Phys. 45(11), 4955\u20134963. https:\/\/doi.org\/10.1002\/mp.13198 (2018).","journal-title":"Med. Phys."},{"issue":"1","key":"95708_CR27","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/s13244-017-0582-1","volume":"9","author":"M Posadzy","year":"2018","unstructured":"Posadzy, M., Desimpel, J. & Vanhoenacker, F. Cone beam CT of the musculoskeletal system: Clinical applications. Insights Imaging 9(1), 35. https:\/\/doi.org\/10.1007\/s13244-017-0582-1 (2018).","journal-title":"Insights Imaging"},{"issue":"3","key":"95708_CR28","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.fas.2019.03.006","volume":"26","author":"M Hamard","year":"2019","unstructured":"Hamard, M. et al. Accuracy of cone-beam computed tomography for syndesmosis injury diagnosis compared to conventional computed tomography. Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons 26(3), 265\u2013272. https:\/\/doi.org\/10.1016\/j.fas.2019.03.006 (2019).","journal-title":"Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons"},{"issue":"8","key":"95708_CR29","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.21037\/qims.2019.08.08","volume":"9","author":"G Durastanti","year":"2019","unstructured":"Durastanti, G. et al. Comparison of cartilage and bone morphological models of the ankle joint derived from different medical imaging technologies. Quant. Imag. Med. Surg. 9(8), 1368\u20131382. https:\/\/doi.org\/10.21037\/qims.2019.08.08 (2019).","journal-title":"Quant. Imag. Med. Surg."},{"issue":"3 Suppl. 2","key":"95708_CR30","first-page":"23","volume":"34","author":"A Bernasconi","year":"2020","unstructured":"Bernasconi, A. et al. Foot and ankle measurements on cone beam weightbearing computed tomography. J. Biol. Regul. Homeost. Agents 34(3 Suppl. 2), 23\u201332 (2020).","journal-title":"J. Biol. Regul. Homeost. Agents"},{"issue":"5","key":"95708_CR31","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1016\/j.fas.2019.05.019","volume":"26","author":"M Richter","year":"2020","unstructured":"Richter, M., Lintz, F., de Cesar, N. C., Barg, A. & Burssens, A. Results of more than 11,000 scans with weightbearing CT\u2014Impact on costs, radiation exposure, and procedure time. Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons 26(5), 518\u2013522. https:\/\/doi.org\/10.1016\/j.fas.2019.05.019 (2020).","journal-title":"Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons"},{"issue":"5","key":"95708_CR32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0178540","volume":"12","author":"TM B\u00fccking","year":"2017","unstructured":"B\u00fccking, T. M. et al. From medical imaging data to 3D printed anatomical models. PLoS ONE 12(5), e0178540. https:\/\/doi.org\/10.1371\/journal.pone.0178540 (2017).","journal-title":"PLoS ONE"},{"issue":"4","key":"95708_CR33","doi-asserted-by":"publisher","first-page":"e524","DOI":"10.1016\/j.ejrad.2011.06.001","volume":"81","author":"Z Fourie","year":"2012","unstructured":"Fourie, Z., Damstra, J., Schepers, R. H., Gerrits, P. O. & Ren, Y. Segmentation process significantly influences the accuracy of 3D surface models derived from cone beam computed tomography. Eur. J. Radiol. 81(4), e524-530. https:\/\/doi.org\/10.1016\/j.ejrad.2011.06.001 (2012).","journal-title":"Eur. J. Radiol."},{"issue":"2","key":"95708_CR34","first-page":"66","volume":"4","author":"Z Kresanova","year":"2018","unstructured":"Kresanova, Z. & Kostolny, J. Comparison of software for medical segmentation. Central Europ. Res. J. 4(2), 66\u201380 (2018).","journal-title":"Central Europ. Res. J."},{"key":"95708_CR35","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.jbiomech.2018.12.031","volume":"84","author":"K Matsiushevich","year":"2019","unstructured":"Matsiushevich, K., Belvedere, C., Leardini, A. & Durante, S. Quantitative comparison of freeware software for bone mesh from DICOM files. J. Biomech. 84, 247\u2013251. https:\/\/doi.org\/10.1016\/j.jbiomech.2018.12.031 (2019).","journal-title":"J. Biomech."},{"issue":"1","key":"95708_CR36","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s41205-020-00069-2","volume":"6","author":"T Kamio","year":"2020","unstructured":"Kamio, T., Suzuki, M., Asaumi, R. & Kawai, T. DICOM segmentation and STL creation for 3D printing: A process and software package comparison for osseous anatomy. 3D Printing Med. 6(1), 17. https:\/\/doi.org\/10.1186\/s41205-020-00069-2 (2020).","journal-title":"3D Printing Med."},{"issue":"2","key":"95708_CR37","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1177\/1071100720961315","volume":"42","author":"P Kvarda","year":"2020","unstructured":"Kvarda, P. et al. 3D assessment in posttraumatic ankle osteoarthritis. Foot Ankle Int. 42(2), 200\u2013214. https:\/\/doi.org\/10.1177\/1071100720961315 (2020).","journal-title":"Foot Ankle Int."},{"issue":"6","key":"95708_CR38","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1016\/j.jcms.2020.03.007","volume":"48","author":"Y Chepurnyi","year":"2020","unstructured":"Chepurnyi, Y., Chernohorskyi, D., Prykhodko, D., Poutala, A. & Kopchak, A. Reliability of orbital volume measurements based on computed tomography segmentation: Validation of different algorithms in orbital trauma patients. J. Cranio-Maxillofacial Surgery 48(6), 574\u2013581. https:\/\/doi.org\/10.1016\/j.jcms.2020.03.007 (2020).","journal-title":"J. Cranio-Maxillofacial Surgery"},{"issue":"2","key":"95708_CR39","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.fas.2020.03.013","volume":"27","author":"C Carrara","year":"2021","unstructured":"Carrara, C., Belvedere, C., Caravaggi, P., Durante, S. & Leardini, A. Techniques for 3D foot bone orientation angles in weight-bearing from cone-beam computed tomography. Foot Ankle Surgery: Official J. Europ. Soc. Foot Ankle Surgeons 27(2), 168\u2013174. https:\/\/doi.org\/10.1016\/j.fas.2020.03.013 (2021).","journal-title":"Foot Ankle Surgery: Official J. Europ. Soc. Foot Ankle Surgeons"},{"issue":"3","key":"95708_CR40","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.fas.2014.04.004","volume":"20","author":"M Richter","year":"2014","unstructured":"Richter, M., Seidl, B., Zech, S. & Hahn, S. PedCAT for 3D-imaging in standing position allows for more accurate bone position (angle) measurement than radiographs or CT. Foot Ankle Surgery: Official J. Europ. Soc. Foot Ankle Surgeons 20(3), 201\u2013207. https:\/\/doi.org\/10.1016\/j.fas.2014.04.004 (2014).","journal-title":"Foot Ankle Surgery: Official J. Europ. Soc. Foot Ankle Surgeons"},{"issue":"24","key":"95708_CR41","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.fas.2018.03.001","volume":"25","author":"C de Cesar Netto","year":"2019","unstructured":"de Cesar Netto, C. et al. Influence of investigator experience on reliability of adult acquired flatfoot deformity measurements using weightbearing computed tomography. Foot Ankle Surg 25(24), 495\u2013502 (2019).","journal-title":"Foot Ankle Surg"},{"key":"95708_CR42","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2018.10.008","author":"NC de Cesar","year":"2019","unstructured":"de Cesar, N. C. et al. Hindfoot alignment of adult acquired flatfoot deformity: a comparison of clinical assessment and weightbearing cone beam CT examinations. Foot Ankle Surg. https:\/\/doi.org\/10.1016\/j.fas.2018.10.008 (2019).","journal-title":"Foot Ankle Surg."},{"issue":"2","key":"95708_CR43","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.fas.2020.04.011","volume":"27","author":"D Shakoor","year":"2020","unstructured":"Shakoor, D. et al. Weight-bearing radiographs and cone-beam computed tomography examinations in adult acquired flatfoot deformity. Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons 27(2), 201\u2013206. https:\/\/doi.org\/10.1016\/j.fas.2020.04.011 (2020).","journal-title":"Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons"},{"issue":"3","key":"95708_CR44","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1007\/s00330-013-3028-2","volume":"24","author":"A Hirschmann","year":"2014","unstructured":"Hirschmann, A., Pfirrmann, C. W. A., Klammer, G., Espinosa, N. & Buck, F. M. Upright cone CT of the hindfoot: comparison of the non-weight-bearing with the upright weight-bearing position. Eur. Radiol. 24(3), 553\u2013558. https:\/\/doi.org\/10.1007\/s00330-013-3028-2 (2014).","journal-title":"Eur. Radiol."},{"issue":"2","key":"95708_CR45","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1055\/s-0039-3400452","volume":"7","author":"M Mosca","year":"2019","unstructured":"Mosca, M. et al. Mini bone block distraction subtalar arthrodesis (SAMBB) in the management of acquired adult flatfoot with subtalar arthritis: A modification to the grice-green procedure. Joints 7(2), 64\u201370. https:\/\/doi.org\/10.1055\/s-0039-3400452 (2019).","journal-title":"Joints"},{"issue":"11","key":"95708_CR46","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1177\/1071100720938665","volume":"41","author":"M Mosca","year":"2020","unstructured":"Mosca, M. et al. Outcome after modified grice-green procedure (SAMBB) for arthritic acquired adult flatfoot. Foot Ankle Int. 41(11), 1404\u20131410. https:\/\/doi.org\/10.1177\/1071100720938665 (2020).","journal-title":"Foot Ankle Int."},{"issue":"1","key":"95708_CR47","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s13047-020-00431-x","volume":"13","author":"C Belvedere","year":"2020","unstructured":"Belvedere, C. et al. Correlations between weight-bearing 3D bone architecture and dynamic plantar pressure measurements in the diabetic foot. J. Foot Ankle Res. 13(1), 64. https:\/\/doi.org\/10.1186\/s13047-020-00431-x (2020).","journal-title":"J. Foot Ankle Res."},{"issue":"4","key":"95708_CR48","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1016\/j.cpm.2007.07.003","volume":"24","author":"DH Richie","year":"2007","unstructured":"Richie, D. H. Biomechanics and clinical analysis of the adult acquired flatfoot. Clin. Podiatric Med. Surgery 24(4), 617\u2013644. https:\/\/doi.org\/10.1016\/j.cpm.2007.07.003 (2007).","journal-title":"Clin. Podiatric Med. Surgery"},{"key":"95708_CR49","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/1757-1146-2-22","volume":"2","author":"GS Murley","year":"2009","unstructured":"Murley, G. S., Menz, H. B. & Landorf, K. B. A protocol for classifying normal- and flat-arched foot posture for research studies using clinical and radiographic measurements. J. Foot Ankle Res. 2, 22. https:\/\/doi.org\/10.1186\/1757-1146-2-22 (2009).","journal-title":"J. Foot Ankle Res."},{"issue":"12","key":"95708_CR50","doi-asserted-by":"publisher","first-page":"1999","DOI":"10.1007\/s11548-018-1727-5","volume":"13","author":"A Burssens","year":"2018","unstructured":"Burssens, A. et al. Reliability and correlation analysis of computed methods to convert conventional 2D radiological hindfoot measurements to a 3D setting using weightbearing CT. Int. J. Comput. Assist. Radiol. Surg. 13(12), 1999\u20132008. https:\/\/doi.org\/10.1007\/s11548-018-1727-5 (2018).","journal-title":"Int. J. Comput. Assist. Radiol. Surg."},{"issue":"5","key":"95708_CR51","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1148\/rg.2019190046","volume":"39","author":"DV Flores","year":"2019","unstructured":"Flores, D. V., Mej\u00eda G\u00f3mez, C., Fern\u00e1ndez Hernando, M., Davis, M. A. & Pathria, M. N. Adult acquired flatfoot deformity: anatomy, biomechanics, staging, and imaging findings. Radiogr. A Rev. Publ. Radiol. Soc. North Am. Inc 39(5), 1437\u20131460. https:\/\/doi.org\/10.1148\/rg.2019190046 (2019).","journal-title":"Radiogr. A Rev. Publ. Radiol. Soc. North Am. Inc"},{"issue":"4","key":"95708_CR52","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.fas.2015.10.002","volume":"22","author":"A Burssens","year":"2016","unstructured":"Burssens, A., Peeters, J., Buedts, K., Victor, J. & Vandeputte, G. Measuring hindfoot alignment in weight bearing CT: A novel clinical relevant measurement method. Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons 22(4), 233\u2013238. https:\/\/doi.org\/10.1016\/j.fas.2015.10.002 (2016).","journal-title":"Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons"},{"issue":"1","key":"95708_CR53","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.fas.2018.11.015","volume":"26","author":"M Peiffer","year":"2020","unstructured":"Peiffer, M. et al. Three-dimensional displacement after a medializing calcaneal osteotomy in relation to the osteotomy angle and hindfoot alignment. Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons 26(1), 78\u201384. https:\/\/doi.org\/10.1016\/j.fas.2018.11.015 (2020).","journal-title":"Foot Ankle Surgery Official J. Europ. Soc. Foot Ankle Surgeons"},{"issue":"10","key":"95708_CR54","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1177\/1071100714540890","volume":"35","author":"F Colin","year":"2014","unstructured":"Colin, F., Horn Lang, T., Zwicky, L., Hintermann, B. & Knupp, M. Subtalar joint configuration on weightbearing CT scan. Foot Ankle Int. 35(10), 1057\u20131062. https:\/\/doi.org\/10.1177\/1071100714540890 (2014).","journal-title":"Foot Ankle Int."},{"issue":"1","key":"95708_CR55","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1177\/1071100715600823","volume":"37","author":"N Kr\u00e4henb\u00fchl","year":"2016","unstructured":"Kr\u00e4henb\u00fchl, N., Tschuck, M., Bolliger, L., Hintermann, B. & Knupp, M. Orientation of the subtalar joint: Measurement and reliability using weightbearing CT scans. Foot Ankle Int. 37(1), 109\u2013114. https:\/\/doi.org\/10.1177\/1071100715600823 (2016).","journal-title":"Foot Ankle Int."},{"issue":"12","key":"95708_CR56","doi-asserted-by":"publisher","first-page":"1861","DOI":"10.1002\/jor.22471","volume":"31","author":"EM Spratley","year":"2013","unstructured":"Spratley, E. M., Matheis, E. A., Hayes, C. W., Adelaar, R. S. & Wayne, J. S. Validation of a population of patient-specific adult acquired flatfoot deformity models. J. Orthopaedic Res. Official Publ. Orthopaedic Res. Soc. 31(12), 1861\u20131868. https:\/\/doi.org\/10.1002\/jor.22471 (2013).","journal-title":"J. Orthopaedic Res. Official Publ. Orthopaedic Res. Soc."},{"issue":"1","key":"95708_CR57","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/s0003-9993(95)80041-7","volume":"76","author":"CL Saltzman","year":"1995","unstructured":"Saltzman, C. L., Nawoczenski, D. A. & Talbot, K. D. Measurement of the medial longitudinal arch. Arch. Phys. Med. Rehabil. 76(1), 45\u201349. https:\/\/doi.org\/10.1016\/s0003-9993(95)80041-7 (1995).","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"95708_CR58","unstructured":"Moreau M, Costa-Bertani G (1943) Roentgen study of flat foot. In: Year Book of Radiology. pp 81\u201382"},{"key":"95708_CR59","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.medengphy.2017.10.008","volume":"51","author":"M van Eijnatten","year":"2018","unstructured":"van Eijnatten, M. et al. CT image segmentation methods for bone used in medical additive manufacturing. Med. Eng. Phys. 51, 6\u201316. https:\/\/doi.org\/10.1016\/j.medengphy.2017.10.008 (2018).","journal-title":"Med. Eng. Phys."},{"issue":"4","key":"95708_CR60","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1177\/1071100714558846","volume":"36","author":"ERC Williamson","year":"2015","unstructured":"Williamson, E. R. C., Chan, J. Y., Burket, J. C., Deland, J. T. & Ellis, S. J. New radiographic parameter assessing hindfoot alignment in stage II adult-acquired flatfoot deformity. Foot Ankle Int. 36(4), 417\u2013423. https:\/\/doi.org\/10.1177\/1071100714558846 (2015).","journal-title":"Foot Ankle Int."},{"issue":"8","key":"95708_CR61","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1177\/1071100720925423","volume":"41","author":"J Day","year":"2020","unstructured":"Day,\u00a0 J. et al. Three-Dimensional Biometric Weightbearing CT Evaluation of the Operative Treatment of Adult-Acquired Flatfoot Deformity. Foot Ankle Int. 41(8), 930\u2013936. https:\/\/doi.org\/10.1177\/1071100720925423 (2020).","journal-title":"Foot Ankle Int"},{"issue":"6","key":"95708_CR62","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1177\/1071100717690806","volume":"38","author":"F Lintz","year":"2017","unstructured":"Lintz, F. et al. 3D biometrics for hindfoot alignment using weightbearing CT. Foot Ankle Int. 38(6), 684\u2013689. https:\/\/doi.org\/10.1177\/1071100717690806 (2017).","journal-title":"Foot Ankle Int."},{"issue":"7","key":"95708_CR63","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1177\/1071100720920274","volume":"41","author":"C de Cesar Netto","year":"2020","unstructured":"de Cesar Netto, C. et al. Multiplanar semiautomatic assessment of foot and ankle offset in adult acquired flatfoot deformity\u2014Abstract\u2014Europe PMC. Foot Ankle Int. 41(7), 839\u2013848. https:\/\/doi.org\/10.1177\/1071100720920274 (2020).","journal-title":"Foot Ankle Int."},{"issue":"2","key":"95708_CR64","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1053\/j.jfas.2015.10.004","volume":"55","author":"M Richter","year":"2016","unstructured":"Richter, M., Zech, S., Hahn, S., Naef, I. & Merschin, D. Combination of PedCAT for 3D-imaging in standing position with pedography shows no statistical correlation of bone position with force\/pressure distribution. J. Foot Ankle Surg. 55(2), 240\u2013246. https:\/\/doi.org\/10.1053\/j.jfas.2015.10.004 (2016).","journal-title":"J. Foot Ankle Surg."},{"key":"95708_CR65","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2020.05.007","author":"F Lintz","year":"2020","unstructured":"Lintz, F. et al. Distance mapping of the foot and ankle joints using weightbearing CT: The cavovarus configuration. Foot Ankle Surgery https:\/\/doi.org\/10.1016\/j.fas.2020.05.007 (2020).","journal-title":"Foot Ankle Surgery"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95708-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95708-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95708-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T07:26:46Z","timestamp":1670052406000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95708-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,9]]},"references-count":65,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["95708"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-95708-x","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,9]]},"assertion":[{"value":"25 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16139"}}